Summary & Overview
CPT 0270U: Versiti Coagulation Disorder Panel, NGS 20-Gene Test
CPT code 0270U designates a Proprietary Laboratory Analyses (PLA) test for the Versiti™ Coagulation Disorder Panel, a next-generation sequencing (NGS) assay of 20 genes linked to heritable coagulation disorders. The code matters nationally as precision genetic diagnostics expand clinical pathways for diagnosing bleeding disorders, informing family risk assessment, and guiding specialist evaluation. PLA codes like 0270U are specific to a single manufacturer's test and therefore have particular implications for coverage policy, billing transparency, and lab reporting.
Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context for the panel, the service setting and specimen types, and what payers commonly review when adjudicating claims for PLA genetic tests. The publication also summarizes typical benchmarks and policy considerations relevant to PLA coding, explains common billing modifiers used with laboratory services, and highlights areas where coverage language and prior authorization practices can affect access. Data not available in the input are noted where applicable.
Billing Code Overview
CPT code 0270U is a Proprietary Laboratory Analyses (PLA) code for the Versiti™ Coagulation Disorder Panel performed by Versiti™ Diagnostic Laboratories. The test uses next-generation sequencing (NGS) analysis of 20 genes associated with heritable coagulation disorders, including von Willebrand disease and hemophilia A and B, to assist clinicians in differential diagnosis for symptomatic patients and in evaluating familial risk for inherited bleeding conditions.
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Service type: Genetic diagnostic testing using NGS for heritable coagulation disorders
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Typical site of service: Clinical diagnostic laboratory; specimen types include blood, buccal swab, or amniotic fluid
Clinical & Coding Specifications
Clinical Context
A 28-year-old woman with a lifelong history of mucocutaneous bleeding and a positive family history of bleeding disorders is referred to a hematology clinic for diagnostic evaluation. After initial laboratory testing (CBC, PT/INR, aPTT, von Willebrand factor antigen/activity, and platelet function studies) returns inconclusive for a specific bleeding disorder, the hematologist orders the Versiti™ Coagulation Disorder Panel (0270U) to perform next-generation sequencing of 20 genes associated with heritable coagulation disorders. Specimen collection is typically a peripheral blood draw; alternative specimens such as a buccal swab or amniotic fluid may be used for family cascade testing or prenatal evaluation. The laboratory performs targeted NGS analysis and reports pathogenic, likely pathogenic, and variants of uncertain significance to aid in differential diagnosis, carrier status determination, and familial risk counseling. Typical sites of service include an outpatient hematology clinic for ordering and specimen collection and a certified clinical molecular diagnostics laboratory (Versiti™ Diagnostic Laboratories) for testing and reporting. Clinical workflow: patient evaluation and informed consent → specimen collection (blood, buccal swab, or amniotic fluid) → shipment to the performing laboratory → NGS analysis of the 20-gene panel → laboratory report with variant classification sent to ordering provider → follow-up visit for result interpretation and family risk discussion.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
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